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soner refuses to sign. note that in the signature block. All refusals should be immediately repotted to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM Form 552 is to be retained in the prisoner's files. Section - USMS Prisoner In formation I. Prisoner Nam (Lass First, SD) :t SM
ULES Paget oft Set Offender: K Anus K Registered K K Conviction Registration Violation Form USM•312 Rev 11/17 EFTA00106176 sirloins mates Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM ::43rwaTTIC;N:;, smiko• ; 4 eustatiknoi by die USMS ionise Officer Sections ii AG ill are to be comp
soner refuses to sign, note that in the signature block. All refusals should be immediately repotted to the Office of Interagency Medina! Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files Section I - USMS Prisoner Information I. Prison: Name (Last. First. Mil I?I)
stody. (This form may be replicated via WP) This form replaces BP-5377(58) and BP-317(58) of JUL 91 tp: NOOIMPOWIMINIP EFTA00110580 urinal owes Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM :,4:1Trt g.7.1;;;;43. I IJ ic. im; cv !Wind by die I..;SMS intake Officer. Sections ii oc iii .21t to
If prisoner reuses to sign, note that in the signalize block. An who& should be immediately repotted to the Office of Interagency Medical Services. Prisoner Services Division. The completed LISM form 552 is to be retained in the prisoners files. Section I -1.1SMS Prisoner Information I. Prisoner Name Mast. NV. MI USMS P
ULES Page 2 of I See Offender O Aunt K Registered K K Conviction Registration Violation Form USM•312 Rev 11/17 EFTA00152423 ..t pas autes Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM ::4317:1;:.771ON:;. itt tot! tbriipivivd by Ule USiviS intake Officer. Sections ii AG iii are ro be
soner refuses to sign. note that in the signature block. All refusals should be immediately reported to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files. Section 1 - USMS Prisoner Information I. Prisoner Name (Last. Fint MB 12. I
nder: CI Arrest ID Registered K E Conviction Registration Violation Form USU-312 Rev 11/17 USAO_002266 EFTA_00020176 EFTA00169869 ltal awes Marshals Service (USMS) PRISONER MEDICAL RECORDS RELEASE FORM iv a its cimipicimi uy oil: USMS intake Officer. Sections ii & iii are to be completed by the prisone
soner refuses to sign, note that in the signature block. All refusals should be immediately reported to the Office of Interagency Medical Services. Prisoner Services Division. The completed USM form 552 is to be retained in the prisoner's files. Section I - USMS Prisoner Information I. Prisoner Name Mast. First. Ml) USM
our arrester-, as you are the responsible party. United States Marshals Service Policy and Procedure: Manual 5.1-1.(a) EFTA01699630 ‘mccou states Marshals Service (USMSI PRISONER MEDICAL RECORDS RELEASE FORM svavo ; I, iV U completed by the USMS intake OfFiCCT. Sections ii It Hi arc to be completed by the pr
Entities connected to both Prisoner Services Division and Marshals Service

Department of Justice
ORGANIZATION
Jeffrey Epstein
PERSONSouthern District
LOCATIONthe Office of Interagency Medical Services
ORGANIZATIONControl as Remanding Receipt
ORGANIZATIONOPTIONAL
ORGANIZATIONUnited States Marshals Service
ORGANIZATION
United States
LOCATIONUSMS 312
ORGANIZATIONCopy of Complaint
ORGANIZATION
Prince Andrew
PERSONLeon Black
PERSONNO PROPERTY NO PROPERTY NO
ORGANIZATIONDistrict File
ORGANIZATIONREMANDS
ORGANIZATION
George W. Bush
PERSOND O.B.
ORGANIZATIONthe United States Marshals Service
ORGANIZATIONAttache
ORGANIZATIONBirth SSN
PERSON